Open AccessNeonatal Hypoxic-Ischemic Encephalopathy: Multimodality Imaging Findings
Author(s) -
Christine P. Chao,
Christopher G. Zaleski,
Alice Patton
Publication year - 2006
Publication title -
radiographics
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.866
H-Index - 172
eISSN - 1527-1323
pISSN - 0271-5333
DOI - 10.1148/rg.26si065504
Subject(s) - medicine , encephalopathy , hypoxic ischemic encephalopathy , brainstem , germinal matrix , periventricular leukomalacia , magnetic resonance imaging , neuroimaging , intraventricular hemorrhage , anesthesia , pathology , radiology , gestational age , pregnancy , psychiatry , biology , genetics
Diffuse hypoxic-ischemic brain injury in the neonate results in neonatal hypoxic-ischemic encephalopathy (HIE). Because of differences in brain maturity at time of insult, severity of hypotension, and duration of insult, there are four distinct patterns of brain injury. Cranial ultra-sonography and computed tomography reveal periventricular leukomalacia, germinal matrix hemorrhage, and hydrocephalus. Magnetic resonance imaging is the most sensitive modality for evaluating the patterns of brain injury. In preterm neonates, mild hypotension causes periventricular injury; severe hypotension results in infarction of the deep gray matter, brainstem, and cerebellum. In term neonates, mild hypotension causes parasagittal cortical and subcortical injury; severe hypotension causes characteristic injury of the lateral thalami, posterior putamina, hippocampi, corticospinal tracts, and sensorimotor cortex. Prompt recognition of these imaging findings can help exclude other causes of encephalopathy, affect prognosis, and facilitate earlier (although mostly supportive) treatment.